Pilot trial to Evaluate the effect of early multi-disciplinary care on chronicity of transport accident injuries

Participants will be stratified to these pathways based on their clinical presentation and validated risk stratification tools. Pathway 1 Telehealth Physiotherapy Unlimited care for up to three months. Treatment may include; a) Advice and education regarding whiplash injury, usual care guidlines, encouragement to stay gently active and gradually re-engage with usual activities. b) Exercise prescription including moderate-intensity cardiovascular activities, motor control and resistance exercises in line with standard prescription guidelines. c) Telehealth session duration will be based on the needs of the client, initial sessions will generallhy take 60 minutes, with follow up sessions taking between 10-30mins. d) The health pathway can be delivered for up to 3-months, but some patients may feel like they are recovered or managing independently before this time and thus won't have to continue to attend telehealth sessions. e) Training will be provided by the Chief Investigator in the delivery of Stress-Inoculation training and this will take 6-hours. f) Training will be delivered prior to recruitment of the first trial participant AND will be delivered either via 1x 6-hour in-person session or 3 x 2-hour online sessions at the therapists preference. g) Participant adherance with treatment will be monitored via verbal report during sessions and is not being reported on for this trial. Referred to this pathway if: 1) They are “low-risk” according to WhipPredict and Orebro SF a. i.e. NDI < 32%, aged < 35 years old. Delivered by experienced physiotherapists specifically trained to deliver the project intervention. Key components: 1) Advice and education regarding their condition; 2) Goal setting and exploration of meaningful life activities; 3) Graded return to activity; and 4) Exercise prescription. Pathway 2 Shared-care Pathway 1 + up to 5 sessions of Face-to-Face Physiotherapy with a local provider. Referred to this pathway if: 1) They have a preference for in-person care; 2) In-person assessment is warranted (e.g. signs of sensorimotor impairments); and/or 3) In-person treatment is warranted (e.g. recalcitrant movement restriction). Treatment may include; a) Usual, pragmatic physiotherapy care including advice and education, exercise prescription, manual therapy, use of external physical devices (e.g. taping), and judicious use of electrophysical agents. b) Face to face sessions will be 30 minutes in lenght . c) Examples exercises that may be prescribed during F2F sessions that are less easily prescibed during telehealth sessions include kineaesthetic awareness training using a laser headlamp. Within this pathway, the care is shared between the face-to-face provider and the expert telehealth physiotherapist. This shared-care will involve collegial support, feedback and peer-review. Barriers to recovery and targets for intervention will be identified and discussed, and advice on current best-practice management will be provided. Liaison will also ensure that care is being delivered efficiently, without doubling up, and is aligned with the participants goals. Liaison will occur in writing and via telephone and/or videoconferencing engagements. There is no prescribed schedule of communication between the therapists, beyond the instruction that contact should be made for every trial participant and then pragmatically as they see fit. Pathway 3 Multidisciplinary care Pathway 1 + Pathway 2 + up to 6, 1-hour sessions of Psychology delivered by a registered in-house Psychologist.in-house Axis Psychologist. Referred to this pathway if at high-risk of delayed recovery: 1) Whip Predict: aged over 35-years-old, NDI score >40%, Posttraumatic Diagnostic Scale score >6 2) Orebro SF scores of >50/100). Treatment sessions will involve The Psychology intervention will provide Stress Inoculation Training (SIT) and include the following core components: 1) Understanding stress and pain, and abdominal breathing; 2) Muscle relaxation and body scanning; 3) Problem-solving; 4) Coping Statements; 5) Applying Stress Inoculation Training (SIT) to the real world; and 6) Coping skills maintenance.